Keimyung Med J.  2016 Dec;35(2):133-139. 10.0000/kmj.2016.35.2.133.

Relapsing Polychondritis Showing Personality Changes and Cognitive Impairment

• Lee JM
• Lee SY
• Park MS
• Lee YY
• Kim JM
• Kim SH
• Son CN

• KMID: 2362342
• DOI: http://doi.org/10.0000/kmj.2016.35.2.133

Abstract

Relapsing polychondritis is a rare, multisystem autoimmune disease. It is characterized by recurrent inflammation of the cartilage and connective tissues in the body. In this paper, we described a case of relapsing polychondritis initially presented symptoms of cognitive dysfunction and personality changes. A 63-year-old male reprented fever, cognitive impairment and personality changes. Brain magnetic resonance imaging revealed leptomeningeal and periauricular hyperintensities. A cerebrospinal fluid examination showed aseptic meningitis. As he reprented hearing difficulties, audiometry showed the sensory neural hearing loss. On physical examination, erythematous swollen auricles were noted. Auricle biopsy consisted with inflammation with perichondritis. He was diagnosed with relapsing polychondritis accompanied by leptomeningeal meningitis, and treated with methylprednisolone (62.5 mg/day for 3 days) followed by prednisolone 60 mg/day and methotrexate 7.5 mg/week. Fever and painful swellings on the both ears subsided. He showed improvement in cognitive function and personality. Although relapsing polychondritis is rare, it should be considered to be a possible cause of leptomeningeal meningitis.

Keyword

Cognitive impairment; Leptomeningeal meningitis; Personality changes; Relapsing polychondritis

MeSH Terms

Audiometry
Autoimmune Diseases
Biopsy
Brain
Cartilage
Cerebrospinal Fluid
Cognition
Cognition Disorders*
Connective Tissue
Ear
Fever
Hearing
Hearing Loss
Humans
Inflammation
Magnetic Resonance Imaging
Male
Meningitis
Meningitis, Aseptic
Methotrexate
Methylprednisolone
Middle Aged
Physical Examination
Polychondritis, Relapsing*
Prednisolone
Methotrexate
Methylprednisolone
Prednisolone